Prevalence of autoimmune thyroid disease twice as high among adults with COVID-19
Click Here to Manage Email Alerts
Key takeaways:
- The percentage of adults with positive thyroid peroxidase antibodies is more than double among those who have vs. have not had COVID-19.
- Longitudinal studies are needed to examine long-term thyroid function.
Adults hospitalized with COVID-19 are more likely to test positive for thyroid peroxidase antibodies about 3 months after infection than those who did not have COVID-19, according to study findings from researchers in Italy.
In an analysis of data from Papa Giovanni XXIII Hospital in Bergamo, Italy, the prevalence of adults with positive thyroid peroxidase antibodies was more than twice as high among adults admitted due to COVID-19 compared with controls, though the two groups had a similar prevalence of adults who had positive thyroglobulin antibody levels.
“A relatively high proportion of COVID-19 survivors develop both serological and ultrasonographic features of thyroiditis, with only a minority displaying thyroid function test abnormalities,” Silvia Ippolito, MD, an endocrinologist at Papa Giovanni XXIII Hospital, and colleagues wrote in a study published in Frontiers in Endocrinology. “It is thus possible that the activation of immune response occurring during the acute phase of COVID-19 may induce or precipitate the onset of autoimmune thyroid disease in some patients.”
Researchers evaluated data from 599 COVID-19 survivors who were hospitalized between May 2 and July 31, 2020, prior to the release of COVID-19 vaccines. Data were obtained from an electronic health records database. The COVID-19 group was compared with a control group of adults who had one assessment of thyroid peroxidase antibodies or thyroglobulin antibodies performed between 2016 and January 2020 and did not have any thyroid disease in their medical history. Thyroid hormones, thyroid peroxidase antibodies and thyroglobulin antibodies were measured in all participants, with the assays being performed about 3 months after hospitalization in the COVID-19 group. An ultrasound was recommended for adults who had positive antibodies detected.
Of adults who were hospitalized with COVID-19, 14.2% had thyroid peroxidase antibodies above the normal range, 7.2% had thyroglobulin antibodies above the normal range, and 3.8% were positive for both antibodies. The overall prevalence of thyroid autoimmunity was 17.5% in the group. Of 498 adults in the control group, 8.3% had thyroid peroxidase antibodies above the normal range, 8.8% had thyroglobulin antibodies above the normal range and 4.3% had high levels of both types of antibodies, the researchers reported.
The median thyroid-stimulating hormone level was 1.55 mIU/L among COVID-19 survivors, with 5% having an abnormal TSH value. Of 11 adults with a TSH level greater than 5 mIU/L, nine had normal free thyroxine levels, indicating subclinical hypothyroidism. Of those with thyroid autoimmunity, 9.6% had abnormal TSH levels.
There were 59 adults who underwent a thyroid ultrasound a median 23 days after their blood test. Of the subgroup, 94.9% had features of thyroiditis. Mean thyroid volume was 11.5 mL in men and 9.5 mL in women, according to the study.
In a sensitivity analysis, 330 adults hospitalized with COVID-19 were matched by age and sex with 330 adults in the control group. The COVID-19 group had a higher prevalence of positive thyroid peroxidase antibodies than the control group (15.7% vs. 7.7%; P = .002), but both groups had a similar prevalence for positive thyroglobulin antibodies. The COVID-19 group had a higher median thyroid peroxidase antibody level (40 U/mL vs. 31 U/mL; P < .001) and a greater median thyroglobulin antibody level (18 U/mL vs. 14 U/mL; P < .001) than the control group.
“Since the development of thyroid autoimmunity usually precedes the onset of thyroid dysfunction, further longitudinal studies are needed to evaluate thyroid function in a long-term follow-up,” the researchers wrote. “Accordingly, the assessment of thyroid peroxidase antibodies and thyroid function tests could be considered in patients evaluated for long COVID, as symptoms of this condition may overlap with those associated with autoimmune thyroid disease.”
Collapse
Read more about
Click Here to Manage Email Alerts